Early Beginning of Alemtuzumab: Changing the Multiple Sclerosis Treatment Paradigm. Interim Analysis of the LEMVIDA Study.

Introduction: LEMVIDA is a real -world prospective study of 3 -year follow-up on quality of life of patients with multiple sclerosis (MS) receiving alemtuzumab in Spain. Methods: This is an interim analysis evaluating the baseline characteristics of patients who started alemtuzumab between October 2016 -September 2018. For 3 additional subanalysis patients were categorized by baseline EDSS score; time of alemtuzumab initiation during the recruitment period (cohort 1: October 2016 -March 2017, cohort 2: April -September 2017, cohort 3: October 2017 -March 2018 and cohort 4: April -September 2018); and the presence of highly active MS criteria. Results: 161 patients were analyzed: 67.1% female, age 38.7 +/- 9.4 years, MS duration 8.5 +/- 6.0 years, EDSS 3.3 +/- 1.7 and number of relapses in the previous 2 years 1.8 +/- 1.3. 48.3% of patients presented gadolinium -enhanced (Gd +) lesions (mean: 5.2 +/- 6.9) and 63.1% had received prior treatment with fingolimod or natalizumab. Baseline EDSS scores and number of Gd + lesions were higher in cohort 1 than in cohort 4 (4.1 +/- 1.8 vs . 3.2 +/- 1.7; p = 0.040 and 10.9 +/- 11.9 vs 4.5 +/- 5.7; p = 0.020). The frequency of prior treatment with fingolimod and natalizumab was lower in cohort 4 (60.6%) than in cohort 1 (70.6%) (comparison between groups not analyzed). Conclusions: Unlike phase 3 studies of alemtuzumab, the patients included in LEMVIDA are older, have a longer duration of MS, higher disability and have received previous immunosuppressants. However, throughout the recruitment period, there is a tendency towards an early beginning of treatment with alemtuzumab, probably due to the evidence of higher effectiveness in the early stages of MS. (c) 2024 Sociedad Espa & ntilde;ola de Neurolog & iacute;a. Published by Elsevier Espa & ntilde;a, S.L.U. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).